A top health system in the country was struggling with the challenges of a fragmented infrastructure. The pandemic was causing additional strain on their systems, and they realized their clinical infrastructure was not scaling to meet changing needs. Their health network and affiliate organizations were challenged with managing data from a variety of disconnected electronic health record (EHR) systems, which made it difficult to access accurate insights on patients in the network.
By moving to a cloud platform, they were able to address one of the biggest obstacles in the transition to value-based care: fragmented healthcare data. They created a 360-degree view of all data related to cost, utilization, risk, and quality, and consolidated it into one patient record, which became the single source of truth.
Fragmented data impedes population health management, care coordination, price transparency mandates, and value-based reimbursement. All those initiatives require the ability to access clinical, financial, and operational data sets.
“Analytics tend to be limited due to data fragmentation and a lack of standardized digitalization,” says Meltem Kutik, Senior Director of Growth Strategy at Innovaccer. “Payers are chasing and cleaning data sets, or they are creating data sets manually for different use cases.”
Payers often rely on months-old, stale-claims data that isn’t current with the EHR or patient-generated data. As a result, they struggle to coordinate care and align incentives under value-based care arrangements.
A lack of analytics hinders innovation and contributes to the administrative complexity that’s linked to more than $265 billion in unnecessary annual healthcare spending in the United States.
“Investing in multiple solutions contributes to creating additional silos,” notes Kutik. “It involves building expertise in using new solutions, ensuring out-of-the-box integration, allocating resources, and managing and maintaining multiple solutions.”
Data for greater insight from a 360-degree patient view
The greatest benefit of a cloud-based health data platform is the 360-degree view. Providers are no longer limited to their EHR data. Data from claims, employers, labs, and patient-generated sources provides a complete view of the patient, leading to more accurate diagnoses and better treatment decisions.
“The cloud data platform enables the ingestion of data from various sources, and once it’s on the platform, it’s no longer fragmented,” says Amy Berk, MSN, RN, Director of Population Health at Microsoft. “You’re no longer limited to the internal data sets that you’ve traditionally used.”
With access to the same data, reports, and recommendations, the cloud platform builds a foundation for greater collaboration. EHR systems can tap into the platform and receive alerts at the point of care, avoiding out-of-network referrals or excluded medications. Collaborators can view a unified member record, use the data to extract insights for meaningful action, align incentives, and enjoy shared savings.
Care models are changing to make way for data
As physicians incorporate health data from multiple sources as part of their standard clinical practice, care models are changing. According to a Deloitte survey, 83 percent of physicians expect patient-generated data from wearables, apps, and sensors to be integrated with care delivery in the next five to ten years.
“Patient preferences for where they seek care are evolving,” says Kangana Mehta, Senior Director of Growth Strategy, Payers at Innovaccer. “Payers can’t just look at the financial and operational side of healthcare anymore. They need to create a marketplace of data, information, and care capabilities that can serve patient preferences beyond the primary care and inpatient setting.”
Cloud-based health data platforms make data standardized and ready for analysis, allowing payers, providers, and collaborators to align incentives and reap the benefits of shared savings. Moving to a health cloud gives payers the data platform that they need to gain a view of individual members and entire populations. This helps reduce the cost of care while improving care quality and patient and provider experiences, all of which are cornerstones of value-based care.
To learn more, download the white paper coauthored by Microsoft and Innovaccer: From Siloed to Seamless: Consolidate Payer Data to Improve Savings, Outcomes, and the Member Experience.